Important Notice Illinois Notice of Health Plan Coverage for Eligible Dependents under the Age of 26

As part of the federal Patient Protection and Affordable Care Act (more commonly
known as Health Care Reform), dependents under the age of 26 — regardless of
marital status — may be eligible for coverage under your employer sponsored health
plan (medical, vision and/or dental benefits), if dependent coverage is offered.
In addition, under Illinois law, any unmarried dependent child under 30 years of
age is eligible for dependent coverage if the dependent meets all three (3) of the
following conditions:
i. is an Illinois resident,
ii. served as an active or reserve member of any U.S. Armed Forces and
iii. received release or discharge other than dishonorable discharge
Enrollees must submit to the insurer a form approved by the Illinois Department of
Veterans’ Affairs stating the date on which the dependent was released from service.
Please note your employer may require you to pay for all or part of the cost of your
dependent’s health care coverage.